Anaphylactoid reaction to maltose 5% solution during spinal anaesthesia.
OBJECTIVE
A rare case of an anaphylactoid reaction to maltose solution is presented.


METHODS
A 28-yr-old man underwent repair of bilateral inguinal hernia under spinal anaesthesia with dibucaine. At the end of operation, he developed generalized flush and circulatory collapse immediately after receiving Na acetate solution containing maltose, 5%, i.v. The reactions were treated with 32 mg ephedrine and 250 mg methylprednisolone i.v., and rapid infusion of 1,000 ml acetated Ringer's solution. The skin tests provoked positive responses to maltose solutions.


CONCLUSIONS
The clinical features and skin tests suggested that the episode was an anaphylactoid reaction to maltose. Maltose is one of the dissacharides (MW: 342) produced from starch and glycogen. Maltose solutions are used frequently in Japan as a carbohydrate source. Further study is required to confirm whether maltose has an immunological antigen-eliciting activity.
Enokibori
M
M
Department of Anesthesiology, Kyoto University Hospital, Japan.
Kuge
M
M
Mori
K
K
D018663:Adrenergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000188:drug therapy; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000941:Antigens / Q000096:biosynthesis; D003992:Dibucaine / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology*; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use; D005483:Flushing / Q000139:chemically induced; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008320:Maltose / Q000009:adverse effects* / Q000276:immunology; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D015532:Rehydration Solutions / Q000009:adverse effects* / Q000627:therapeutic use; D012769:Shock / Q000139:chemically induced; D012882:Skin Tests; D019346:Sodium Acetate / Q000009:adverse effects / Q000627:therapeutic use
D018663:Adrenergic Agents; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D000941:Antigens; D005938:Glucocorticoids; D007552:Isotonic Solutions; D015532:Rehydration Solutions; C028570:Ringer's acetate; D019346:Sodium Acetate; D008320:Maltose; D004809:Ephedrine; D003992:Dibucaine; D008775:Methylprednisolone